Necrotizing Fasciitis: Current Concepts, Pathogensand Management

Abstract

Abstract:Necrotizing fasciitis (NF) is a severe disease of sudden onset that spreads rapidly. The disease is more common in the adults Medical imaging is helpful to confirm diagnosis. Initial treatment includes a combination of intravenous antibiotics including piperacillin/tazobactam, vancomycin, and clindamycin or ampicillinsulbactam combined with metronidazole, clindamycin or carbapenems(imipenem).Aggressive surgical debridement is always necessary. Amputation of infected limb(s) may be necessary. Ancillary therapies, neither a substitute for surgical debridement nor proven efficacy have been described. Some studies recommend using intravenous immunoglobulin (IVIG).Nutritional support is imperative. High mortality rates if left untreated. High index of suspicion and knowledge is essential for early diagnosis and outcomes of NF.

Early Detection of Necrotizing Fasciitis Secondary to Group A Streptococcus: A Case Report

“…[4,5] Initial presenting features may include erythema not sharply demarcated, edema, tenderness, skin lesions, blister formation, ulceration, necrosis, crepitus, pain out of proportion, and subcutaneous tissue induration. [1,6] Overlying tissue may appear unaffected despite underlying fascial infection. [6] Surgical intervention is the only definitive modality to differentiate between NF, myositis, and pyomyositis.…”

“…[1,6] Overlying tissue may appear unaffected despite underlying fascial infection. [6] Surgical intervention is the only definitive modality to differentiate between NF, myositis, and pyomyositis. [2] Although it may be difficult to diagnose NF without direct visualization of the infected soft tissue, it is imperative to begin management immediately to limit morbidity and mortality.…”